Essential nursing care of the critically ill patient

This chapter is about essential nursing care. Because it is often referred to as basic nursing, nurses may not always perceive it as deserving of priority. Yet, how well patients are cared for has a direct effect on their sense of wellbeing and their recovery. ‘Interventional patient hygiene’ is a systematic, evidence-based approach to nursing actions designed to improve patient outcomes using a framework of hygiene, catheter care, skin care, mobility and oral care.1 This chapter focuses on the physical care, infection control, preventative therapies and transport of critically ill patients. The first two areas are closely linked: poor-quality physical care increases the risk of infection. The final areas are essential features of critical care nursing.

An 8000-year history of landscape, climate and copper exploitation in the Middle East: the Wadi Faynan and the Wadi Dana National Reserve in southern Jordan

Investigations of geomorphology, geoarchaeology, pollen, palynofacies, and charcoal indicate the comparative scales and significance of palaeoenvironmental changes throughout the Holocene at the junction between the hyper-arid hot Wadi â??Arabah desert and the front of the Mediterranean-belt Mountains of Edom in southern Jordan through a series of climatic changes and episodes of intense mining and smelting of copper ores. Early Holocene alluviation followed the impact of Neolithic grazers but climate drove fluvial geomorphic change in the Late Holocene, with a major arid episode corresponding chronologically with the â??Little Ice Ageâ?? causing widespread alluviation. The harvesting of wood for charcoal may have been sufficiently intense and widespread to affect the capacity of intensively harvested tree species to respond to a period of greater precipitation deduced for the Roman-Byzantine period - a property that affects both taphonomic and biogeographical bases for the interpretation of palynological evidence from arid-lands with substantial industrial histories. Studies of palynofacies have provided a record of human and climatic causes of soil erosion, and the changing intensity of the use of fire over time. The patterns of vegetational, climatic change and geomorphic changes are set out for this area for the last 8000 years.

General Nurses’ Experiences of End-Of-Life Care in the Acute Hospital Setting

Approximately 90% of the UK population spend some time in hospital in their final year of life, and more than half of the population die in hospital. This review aims to explore the experiences of general nurses when providing end-of-life care to patients in the acute hospital setting. Nine studies were identified through a literature search, and each was then analysed and evaluated until themes emerged. Six themes were drawn from the literature: lack of education and knowledge, lack of time with patients, barriers arising in the culture of the health-care setting, communication barriers, symptom management, and nurses' personal issues. The themes cause concern about the quality of end-of-life care being provided in the acute care setting. The literature appears to be consistent in the view that terminally ill patients are best cared for in specialised care settings, such as palliative care units and hospices. However, increasing demands on health services will result in greater numbers of dying patients being admitted to the acute hospital setting. It is therefore paramount that general nurses' educational needs are met to ensure they develop clinical competence to provide high-quality holistic end-of-life care.

Evaluation of an Older Persons’ Assessment Educational Workbook with second year nursing students in the UK.

Background: As a first step to successfully meet the complex health and social needs of older people, patient assessment has become a central feature of government policy and practice in order to ensure that care planning is person-centred. A core component of nurse education is clinical practice in order to support the development of clinical skills and competence; therefore it is important to help students and their practice-based mentors to develop and apply older person assessment skills. Therefore, an educational workbook was developed to help 2nd year nursing students to learn a structured, systematic and individualised older person assessment process with the support of their mentor.

Aim: A pilot study to evaluate the impact of an Older Persons’ Assessment Educational Workbook and explore second year nursing students’ competence and their opinions and use of an older person’s assessment skills workbook.

Research Methodology: A pre-experimental design (pre and post-test with no comparison group) was undertaken with n=6 2nd year students in 2014. The outcome measure was the Nursing Competence Questionnaire and results were analysed using the Wilcoxin Signed Rank Test in SPSS version 21. Content analysis of completed workbooks and a survey (n=5) of opinions regarding the workbook was undertaken.

Key Findings- No pre-post-test difference was found in the Nursing Competence Questionnaire with p=0.058 for the total scale. However, as this was a pilot, the study was under-powered and all students’ scores improved. Content analysis of the workbook found that 3 of the 5 participants completed all components of the workbook, with a mean of 1051 words used (Std dev 281.8). Through the survey students reported the workbook as a useful guide when undertaking a patient assessment.

Conclusions: The workbook showed potential as an intervention to help support development of nursing students’ assessment skills in practice.

Potential for clean yam minisett production by resource-poor farmers in the middle-belt of Nigeria

Yarn minisett technique (YMT) has been promoted throughout West Africa since the 1980s as a sustainable means of producing clean yarn planting material, but adoption of the technique is Often reported as being patchy at best. While there has been much research Oil the factors that influence adoption of the technique, there have been no attempts to assess its economic viability under 'farmer-managed' as distinct from 'on station' conditions. The present paper describes the results of farmer-managed trials employing the YMT (white yarn: Dioscorea rotundata) at two villages in Igalaland, Kogi State, Nigeria. One of the villages (Edeke) is on the banks of the River Niger and represents it specialist yarn environment, whereas the other village (Ekwuloko) is inland, where farmers employ a more general cropping system. Four farmers were selected in each of the two villages and asked to plant a trial comprising two varieties of yam, their popular local variety its well its another variety grown in other parts of Igalaland, and to treat yarn setts (80-100 g) with either woodash or insecticide/nematicide + fungicide mix (chemical treatment). Results suggest that while chemical sett treatment increased yield and hence gross margin compared with woodash, if household labour is costed then YMT is not economically viable. However, the specialist yarn growers of Edeke were far more positive about the use of YMT as they tended to keep the yarn seed tubers for planting rather than sell them. Thus, great care needs to be taken with planning adoption surveys on the assumption that all farmers should adopt a technology.

Financial comparisons of the artisanal fisheries in Urubupungá Complex in the middle Paraná River (Brazil)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Generating Interest in Mathematics Using Discussion in the Middle School Classroom

In this action research study of my classroom of 8th grade algebra, I investigated students’ discussion of mathematics and how it relates to interest in the subject. Discussion is a powerful tool in the classroom. By relying too heavily on drill and practice, a teacher may lose any individual student insight into the learning process. However, in order for the discussion to be effective, students must be provided with structure and purpose. It is unrealistic to expect middle school age students to provide their own structure and purpose; a packet was constructed that would allow the students to both show their thoughts and work as a small group toward a common goal. The students showed more interest in the subject in question as they related to the algebra topics being studied. The students appreciated the packets as a way to facilitate discussion rather than as a vehicle for practicing concepts. Students still had a need for practice problems as part of their homework. As a result of this research, it is clear that discussion packets are very useful as a part of daily instruction. While there are modifications that must be made to the original packets to more clearly express the expectations in question, discussion packets will continue to be an effective tool in the classroom.

Production of nursing care in primary health care services

This descriptive and quantitative study aimed to characterize the production of nursing care in primary health care services in a region of the city of Ribeirao Preto, state of Sao Paulo, Brazil. The study sample comprised care actions delivered by nurses and registered in the HygiaWeb Information System, from 2006 to 2009. Statistical analysis was performed. Results showed that nursing care delivered by nurses accounted for 9.5 to 14.6% of total professional care provided by professionals. Eventual care actions were the most frequent. The concentration of programmatic care was higher for children, women, pregnant and postpartum women. In conclusion, the predominance of eventual care demonstrated that the health system has been focused on acute conditions. Little of nursing work has been directed at the achievement of comprehensiveness, considering the inexpressive share of longitudinal follow up in total care delivery. The expansion of nursing staff represents potential for care delivery to the population, but further qualification of nursing actions is needed.

Palliative care in the home: perceptions of nurses in the Family Health Strategy

OBJECTIVE: To understand the perception of nurses from the Family Health Strategy in relation to palliative care in the home. METHODS: A descriptive, exploratory study with a qualitative approach conducted with nine nurses from the Family Health Strategy of the municipality of Lavras - MG. Semi-structured interviews were conducted and data were subjected to content analysis. RESULTS: The various dimensions of care in the home context were identified, along with the performance and limitations of nurses in the care of the patient and his family at end of life. The capacity to establish a bond, by the proximity to people who receive their care, is a remarkable point of the action of these nurses with patients and families in end of life situations. CONCLUSION: The nurses consider the patient and his family as the unit of care, they have the opportunity to share solidarity, experiences and learning, not only from a professional standpoint, but above all, from a human one.

Significance of the Philosophy of Family-Centered Care in the

The philosophy of family-centered care is “an approach to the planning, delivery, and evaluation of healthcare that is grounded in mutually beneficial partnerships among patients, families and healthcare practitioners” (Children’s Hospital of Philadelphia, 1996-2008). The word “family” refers to “two or more persons who are related in any way-biologically, legally, or emotionally” (Institute for Family-Centered Care). It is patients and families, who define those included in their families, which usually in pediatrics includes parents or guardians.